Anatomy

Question 1

What structures of the female reproductive system lie within the pelvic cavity?

Answer 1

ovaries
uterine tubes
uterus
superior part of vagina

Question 2

What structures of the female reproductive system lie within the perineum?

Answer 2

inferior part of vagina
perineal muscles
Bartholin's glands
clitoris
labia

Question 3

What structure usually indicates the boundary between the pelvic cavity and perineum?

Answer 3

pelvic floor muscles

Question 4

What pouches are formed by the floor of the peritoneum?

Answer 4

vesico-uterine pouch

recto-uterine pouch (pouch of Douglas)

Question 5

What is the clinical significance of the pouch of Douglas?

Answer 5

Excess (abnormal) fluid within the peritoneal cavity tends to collect within the pouch of Douglas as it is the most inferior part of the peritoneal cavity in the anatomical position

Question 6

How is fluid drained from the pouch of Douglas?

Answer 6

can be drained with a needle passed through the posterior fornix of the vagina

Question 7

Describe the Broad ligament of the uterus

Answer 7

double layer of peritoneum
extends between the uterus and the lateral walls and floor of the pelvis
helps maintain the uterus in its correct midline position
contains within it the uterine tubes and the proximal part of the round ligament

Question 8

Describe the Round ligament of the uterus

Answer 8

an embryological remnant of the gubernaculum (which also forms the ovarian ligaments)
attaches to the lateral aspect of the uterus
passes through the deep inguinal ring to attach to the superficial tissue of the female perineum
proximally is contained within the broad ligament

Question 9

What are the 3 layers of the uterus?

Answer 9

perimetrium
myometrium
endometrium

Question 10

What are the 3 layers of support which hold the uterus in position?

Answer 10

a number of strong ligaments (e.g. uterosacral ligaments)
endopelvic fascia
muscles of the pelvic floor (e.g. elevator ani)

Question 11

Name 4 common O&G surgical incisions

Answer 11

Lower segment caesarean section (LSCS)
laparotomy
abdominal (and vaginal) hysterectomy
laparoscopy

Question 12

what part of the uterus does a LSCS go through

Answer 12

lower part of uterus

Question 13

What are the layers of the lateral abdominal wall, superficial to deep?

Answer 13

skin
superficial fascia
external oblique
internal oblique
transversus abdominis
(all these muscles have their own aponeuroses)

Question 14

what are the layers of the anterior abdominal wall, superficial to deep?

Answer 14

skin
superficial fascia
rectus sheath
rectus abdominis

Question 15

What are the attachments of the eternal oblique muscles? What direction do the fibres run in?

Answer 15

attach between lower ribs and iliac crest; and pubic tubercle and line alba (in the midline)
inferomedially - same direction as external intercostals

Question 16

what is the linea alba in the abdominal wall?

Answer 16

midline blending of aponeuroses of abdominal muscles

Question 17

What are the attachments of internal obliques? what direction do the fibres run in?

Answer 17

attach between lower ribs, thoracolumbar fascia; iliac crest and linea alba
fibres run superomedially - same direction as internal intercostals

Question 18

What are the attachments of transverses abdominis?

Answer 18

attach between lower ribs, thoracolumbar fascia, iliac crest and linea alba

Question 19

What are the principle supports of the uterus?

Answer 19

Transverse cervical ligaments (cardinal ligaments)
Uterosacral ligaments
Round ligament

Question 20

What structures attach the ovary to the uterus?

Answer 20

infundibular ligament
mesovarium
blood supply

Question 21

Where does the blood supply to the ovaries arise from?

Answer 21

renal arteries

Question 22

Where is the pouch of Douglas located?

Answer 22

Between the uterus and the rectum

Question 23

Where does the urethra lie in relation to the vagina?

Answer 23

anterior to the lower third of the vagina

Question 24

Where does the empty bladder lie in relation to the body of the uterus?

Answer 24

Anterior and below: lies below the uterovesical fold which arises from the junction between the uterine body and the cervix